Indents on either side of nose post under eye filler. Should I dissolve?

Question

I had under eye filler just under 2 years ago. Just recently I began noticing indents on either side of my nose. Is this from migrating filler or another issue? Should I dissolve?

Shaden Mohammad, MD · Answer

Ultrasound is a great tool to be able to identify if the apparent indent is related to near by filler (creating a peak and valley appearance). We've had many patient present with a similar appearing "dent" that is most evident when smiling. Using ultrasound-guidance, we are able to identify, target and dissolve the problematic filler with great results. Best of Luck! Dr. Shaden, Woodland Hills, CA

Jeffrey H. Spiegel, MD · Answer

Under eye volume loss may be one of the  hardest areas to treat. It's best to inject the needed amount of hyaluronic acid once due to the potential bruising in the area. Even after great initial results there can be changes in the area due to sleeping habits and hydration as a result of salty foods or alcohol. If you see any lumps, as in your case, heavy icing and using some hyaluronidase to open up the filler should help. I also recommend some IPL treatment to help with pigmentation and collagen rejuvenation. 
Hope this helps. Best, from Boston.

Nelson Lee Novick, MD · Answer

Filler migration, should it occur, typically happens soon after the filler treatment, and so is unlikely the case here. On the other hand, I have personally seen this kind and other variants of filler-related, under-eye problems, known as"puffy pillows," that may occur months to years following treatment. These are believed to be caused by lymphedema or lymphatic obstruction resulting from the use of an inappropriate filler for the under-eye area and/or too superficial placement of the filler in that area.  
I have personally had gratifying results in improving this complication with the use of an algorithm of varying combinations, concentrations and amounts of intralesional anti-inflammatory injections.
You would be wise to consult and seek treatment with an experienced, board certified cosmetic dermatologist filler expert. Hope this helps and best of luck.

Anna Chacon, MD, FAAD · Answer

Hello,

Noticing changes in your facial structure after having had under-eye filler a couple of years ago can be concerning. The indents you're observing on either side of your nose could potentially be due to a few factors:

Filler Migration: It's possible that the filler has migrated slightly from its original placement, which can occasionally happen over time. This might create unevenness or indents in areas near the filler site.

Natural Changes: As we age, natural changes in the facial structure can occur, which might reveal or accentuate areas that were previously not as noticeable.

Volume Loss: Loss of volume in surrounding areas, unrelated to the filler itself, could also contribute to the appearance of indents.

Before deciding to dissolve the filler, consider consulting with a qualified dermatologist or cosmetic surgeon. They can assess your situation in person, review your treatment history, and determine the best course of action. If the indents are due to filler migration, dissolving the filler with hyaluronidase might be an option. However, a professional evaluation is crucial to ensure the correct approach is taken.

Best regards,

Camille Cash, MD · Answer

The contour that concerns you may be related to migrated filler.  If it is, dissolving it with hyaluronidase should help improve it.  Skin laxity and volume loss could also impact the look.  You can consider Morpheus8 treatments to improve overall skin tone and texture.

Indents on either side of nose post under eye filler. Should I dissolve?

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